Early Family Attitudes and the Stress Process—A Life-Span and Personological Model of Host-Tumor Relationships

Biopsychosocial Research on Cancer and Stress in Central Europe
  • Hans-Joachim F. Baltrusch
  • Millard E. Waltz


The marked rise in malignancy, cardiovascular, and other diseases in Central Europe during the present century may be a concomitant of “modernization” and its social sequelae. It has been speculated that changes in the interpersonal environment, associated with increasing levels of social stress and a decrease in coping resources, may be precursors of these “diseases of civilization.” Viewing health and disease within a broad historical-philosophical context, a number of medical and behavioral scientists beginning with Neumann and Virchow emphasized the social nature of disease processes. (1) The former (2) suggested the development of medicine as a social science. The latter, (3) on the basis of clinical observations during the Silesian typhus epidemic of 1847, considered disease to be linked to historical processes and the product of a “false culture.” An extensive body of writings developed in social and psychosomatic medicine. The hypotheses put forth, however, remained highly speculative because of the lack of modern immunoassays and other techniques necessary for probing into the neuroendocrine and immunologic pathways of psychosocial influences. The holistic approaches of Virchow, von Weizsäcker, (4) and other perspicacious observers of the environment-disease interface were partially eclipsed following the rise of a narrow perspective in European medicine.


Social Stress Social Connectedness Coping Resource Maternal Separation Social Ecology 
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  1. 1.
    Rosen, G., 1979, The evolution of social medicine, in: Handbook of Medical Sociology, 3rd ed. ( H.E. Freeman, S. Levine, and L.G. Reeder, eds.), Prentice-Hall, Englewood Cliffs, N.J., pp. 23–52.Google Scholar
  2. 2.
    Neumann, S., 1847, Die öffentliche Gesundheitspflege und das Eigenthum, Adolf Riess, Berlin.Google Scholar
  3. 3.
    Virchow, R., 1848, Die öffentliche Gesundheitspflege, Med. Reform 5: 21–22.Google Scholar
  4. 4.
    von Weizsäcker, V., 1946, Studien zur Pathogenese, 2nd ed., Georg Thieme, Wiesbaden.Google Scholar
  5. 5.
    De Vries, M.J., 1981, The Redemption of the Intangible in Medicine,Psychosynthesis Monographs 1, London.Google Scholar
  6. 6.
    Herd, J.A., and Weiss, S.M. (eds.), 1983, Behavior and Arteriosclerosis, Plenum Press, London.Google Scholar
  7. 7.
    Pinchuk, V.G., 1984, Problems in Current Psychosomatic Studies in Oncology, Opening address of the Fifth Symposium on Stress and Cancer, Kiev, June 1984.Google Scholar
  8. 8.
    Baltrusch, H.J.F., 1975, Ergebnisse klinisch-psychosomatischer Krebsforschung, Psychosom. Med. 5: 175–208.Google Scholar
  9. 9.
    Baltrusch, H.J.F., and Waltz, M., 1985, Cancer from a biobehavioral and social epidemiological perspective, Soc. Sci. Med. 20: 789–794.PubMedCrossRefGoogle Scholar
  10. 10.
    Durkheim, E., 1951, Suicide, Free Press, New York.Google Scholar
  11. 11.
    Cassel, J., 1974, Psychosocial processes and stress: Theoretical formulation, Int. J. Health Serv. 4: 471–482.PubMedCrossRefGoogle Scholar
  12. 12.
    Cassel, J., 1976, The contribution of the social environment to host resistance, Am. J. Epidemiol. 104: 107–122.PubMedGoogle Scholar
  13. 13.
    Henry, J.P., and Stevens, P.M., 1977, Stress, Health, and the Social Environment, Springer, New York.CrossRefGoogle Scholar
  14. 14.
    Joseph, J., and Syme, L., 1982, Social connection and the etiology of cancer: An epidemiological review and discussion, in: Psychosocial Aspects of Cancer ( J. Cohen, J. Cullen, and R. Martin, eds.), Raven Press, New York.Google Scholar
  15. 15.
    Syme, L., and Seeman, T.E., 1983, Sociocultural factors in coronary heart disease, in: Behavior and Arteriosclerosis ( J.A. Herd and S.M. Weiss, eds.), Plenum Press, London, pp. 55–72.CrossRefGoogle Scholar
  16. 16.
    Badura, B. (ed.), 1981, Soziale Unterstützung und chronische Krankheit, Suhrkamp, Frankfurt/Main.Google Scholar
  17. 17.
    Sklar, L., and Anisman, H., 1979, Stress and coping factors influencing tumor growth, Science 205: 513–515.PubMedCrossRefGoogle Scholar
  18. 18.
    Sklar, L., and Anisman, H., 1981, Contributions of stress and coping to cancer development and growth, in: Stress and Cancer ( K. Bammer and B.H. Newberry, eds.), C.J. Hogrefe, Toronto, pp. 98–136.Google Scholar
  19. 19.
    Cox, T., and Mackay, C., 1982, Psychosocial factors and psychophysiological mechanisms in the aetiology and development of cancers, Soc. Sci. Med. 16: 381–396.PubMedCrossRefGoogle Scholar
  20. 20.
    Balitsky, K.P., 1983, Nervnaya Sistema i Protiopucholevaya Zaschlita, Nauka Dumka, Kiev.Google Scholar
  21. 21.
    Lloyd, R., 1984, Mechanisms of psychoneuroimmunological response, in: Impact of Psychoendocrine Systems in Cancer and Immunity ( B.H. Fox and B.H. Newberry, eds.), C.J. Hogrefe, Toronto, pp. 1–57.Google Scholar
  22. 22.
    Solomon, G., 1984, Emotions, immunity and disease: An historical and philosophical perspective, in: Breakdown in Human Adaptation to “Stress, Volume 2 ( R.E. Ballieux, ed.), Martinus Nijhoff, Den Haag, pp. 671–680.Google Scholar
  23. 23.
    Shekelle, R., Raynor, A., and Ostfield, A., 1981, Psychological depression and 17 year risk of death from cancer, Psychosom. Med. 43: 117–125.PubMedGoogle Scholar
  24. 24.
    Schmale, A., and Iker, H., 1966, The effect of hopelessness and the development of cancer, Psychosom. Med. 28: 714–721.Google Scholar
  25. 25.
    Kerr, T.A., Shapira, K., and Roth, M., 1969, The relation between premature death and affective disorder, Br. J. Psychiatry 115: 1277–1282.PubMedCrossRefGoogle Scholar
  26. 26.
    Whitlock, F.A., and Siskind, M., 1979, Depression and cancer: A follow-up study, Psychol. Med. 9: 747–752.PubMedCrossRefGoogle Scholar
  27. 27.
    Levy, S., 1984, Emotions and the progression of cancer: A review, Advances 1: 10–15.Google Scholar
  28. 28.
    Sklar, L., and Anisman, H., 1981, Stress and cancer, Psychol. Bull. 89: 369–406.PubMedCrossRefGoogle Scholar
  29. 29.
    Schulz van Treeck, A., 1954, Krebs and körpereigene Abwehr, Z. Laryngol., Rhinol., Otol. Ihre Grenzgeb. 33: 385–396.Google Scholar
  30. 30.
    Schulz van Treeck, A., 1955, Krebsdisposition und Wesenstypus, Dtsch. Ges u nd h ei tswes. 39: 1273–1278.Google Scholar
  31. 31.
    Grossarth-Maticek, R., 1979, Krankheit als Biographie: Ein medizinsoziologisches Modell der Entstehung und Therapie der Krebserkrankung, Kiepenheuer/Witsch, Cologne.Google Scholar
  32. 32.
    Baltrusch, H.J.F., 1963, Psyche-Nervensystem-Neoplastischer Prozess, Z. Psychosom. Med. 9: 229–238.Google Scholar
  33. 33.
    Baltrusch, H.J.F., 1969, Einige psychosomatische Aspekte der Krebskrankheit unter Berücksichtigung psychotherapeutischer Gesichtspunkte, Z. Psychosom. Med. Psychoanal. 15: 31–37.PubMedGoogle Scholar
  34. 34.
    Baltrusch, H.J.F., and Stangel, W., 1981, Psychosomatic aspects of polycythaemia vera, Psychiatr. Fennica Suppl.: 133–142.Google Scholar
  35. 35.
    Berczi, I., 1983, Cancer immunology—Quo vadis? Exp. Clin. Cancer Res. 2: 135144.Google Scholar
  36. 36.
    Dilman, V., and Ostroumova, M., 1984, Hypothalamic, metabolic, and immune mechanisms of the influence of stress on the tumor process, in: Impact of Psychoendocrine Systems in Cancer and Immunity ( B. Fox and B.H. Newberry, eds.), C.J. Hogrefe, Toronto, pp. 58–85.Google Scholar
  37. 37.
    Spitz, R.A., 1945, Hospitalism: An inquiry into the genesis of psychiatric conditions in early childhood, Psychoanal. Stud. Child 1: 53–62.PubMedGoogle Scholar
  38. 38.
    Shaver, P., and Rubenstein, C., 1980, Childhood attachment experience and adult loneliness, in: Review of Personality and Social Psychology, Volume 1 ( L. Wheeler, ed.), Sage, Beverly Hills, pp. 42–73.Google Scholar
  39. 39.
    Jones, W.H., Hobbs, S.A., and Hockenberry, D., 1982, Loneliness and social skill deficits, J. Pers. Soc. Psychol. 42: 682–689.Google Scholar
  40. 40.
    Weeks, D.G., Michaela, J.L., Peplau, L.A., and Bragg, M.E., 1980, The relation between loneliness and depression, J. Pers. Soc. Psychol. 39: 1238–1244.Google Scholar
  41. 41.
    Peplau, L.A., and Perlman, D. (eds.), 1982, Loneliness: A sourcebook of current theory, research and therapy, Wiley-Interscience, New York.Google Scholar
  42. 42.
    Dilman, V.M., 1983, Endokrinologiceskaya Onkologia, Meditsina, Leningrad.Google Scholar
  43. 43.
    Borysenko, J., 1982, Higher cortical function and neoplasia: Psychoneuroimmunology, in: Biological Mediators of Behavior and Disease: Neoplasia ( S. Levy, ed.), Elsevier Biomedical, New York, pp. 29–53.Google Scholar
  44. 44.
    Berkman, L., and Syme, L., 1979, Social networks, host resistance and mortality: A nine-year follow-up study of Alameda County residents, Am. J. Epidemiol. 109: 186–204.PubMedGoogle Scholar
  45. 45.
    Berkman, L., 1977, Social Networks, Host Resistance and Mortality: A Follow-Up Study of Alameda County Residents, Doctoral dissertation, University of California, Berkeley.Google Scholar
  46. 46.
    Ruberman, W., Weinblatt, E., Goldberg, J.D., and Chandhary, B.S., 1984, Psychosocial influences on mortality after myocardial infarction, N. Engl. J. Med. 311: 552–559.PubMedCrossRefGoogle Scholar
  47. 47.
    Weisman, A., and Worden, J., 1977, Coping and Vulnerability in Cancer Patients, Harvard University, Boston.Google Scholar
  48. 48.
    Bradburn, N., 1969, The Structure of Well-Being, Aldine, Chicago.Google Scholar
  49. 49.
    Pain-tore, E., and Luikart, C., 1972, Health and social factors related to life satisfaction, J. Health Soc. Behay. 13:68–80.Google Scholar
  50. 50.
    Pearlin, L., and Johnson, J., 1977, Marital status, life strains and depression, Am. Sociol. Rev. 42: 704–715.PubMedCrossRefGoogle Scholar
  51. 51.
    Brown, G.W., and Harris, T., 1978, The Social Origins of Depression, Tavistock, London.Google Scholar
  52. 52.
    Zautra, A., 1983, Social resources and the quality of life, Am. J. Comm. Psychol. 11: 275–289.Google Scholar
  53. 53.
    Weiss, R.S., 1974, The provisions of social relationships, in: Doing Unto Others ( Z. Rubin, ed.), Prentice-Hall, Englewood Cliffs, N.J.Google Scholar
  54. 54.
    Weiss, R.S., 1975, Marital Separation, Basic Books, New York.Google Scholar
  55. 55.
    Russell, D., Cutrona, C.E., Rose, J., and Yurko, K., 1984, Social and emotional loneliness: An examination of Weiss’s typology of loneliness, J. Pers. Soc. Psychol. 46: 1313–1321.PubMedCrossRefGoogle Scholar
  56. 56.
    Jacobs, S. and Ostfield, A., 1977, An epidemiological review of bereavement, Psychosom. Med. 39: 344–357.PubMedGoogle Scholar
  57. 57.
    Parkes, C.M., 1972, Bereavement: Studies of Grief in Adult Life, International Universities Press, New York.Google Scholar
  58. 58.
    Bartrop, R., Luckhurst, E., and Lazarus, L., 1977, Depressed lymphocyte function after bereavement, Lancet 1: 834–836.PubMedCrossRefGoogle Scholar
  59. 59.
    Bartrop, R., 1984, Bereavement, T-cell function and possible organic disease, Abstracts of the Fifth Symposium on Stress and Cancer, June 1984, Kiev, EUPSYCA, Oldenburg, W. Germany.Google Scholar
  60. 60.
    Schleifer, S., Keller, S., Camerino, M., Thornton, J., and Stein, M., 1983, Suppression of lymphocyte stimulation following bereavement, J. Am. Med. Assoc. 250: 374–377.CrossRefGoogle Scholar
  61. 61.
    Bloom, B., Asher, S., and White, S., 1978, Marital disruption as a stressor: A review and analysis, Psychol. Bull. 85: 867–894.PubMedCrossRefGoogle Scholar
  62. 62.
    Bloom, B., Hodges, W.F., and Caldwell, R.A., 1983, Marital separation: The first 8 months, in: Life-Span Developmental Psychology: Non-normal Life Events ( E.J. Callahan and K.A. McKluskey, eds.), Academic Press, New York.Google Scholar
  63. 63.
    Van Dyke, C., and Kaufman, C., 1983, Psychobiology of bereavement, in: Emotions in Health and Illness ( L. Temoshok, C. Van Dyke, and L. Zegans, eds.), Grune and Stratton, New York, pp. 37–49.Google Scholar
  64. 64.
    Bauman, L.J., Rogers, T.F., and Metzger, L., 1982, An Empirical Specification of the Concept of Social Support, Paper presented at the annual meeting of the American Sociological Association, San Francisco, September 1982.Google Scholar
  65. 65.
    Lichtman, R., Wood, J., and Taylor, S., 1982, Close Relationships after Breast Cancer, Paper presented at the annual meeting of the American Psychological Association, Washington, D.C., August 1982.Google Scholar
  66. 66.
    DiMatteo, R., and Hays, R., 1981, Social support and serious illness, in: Social Networks and Social Support ( B. Gottlieb, ed.), Sage, London.Google Scholar
  67. 67.
    Cobb, S., 1976, Social support as a moderator of life stress, Psychosom. Med. 38: 300–313.PubMedGoogle Scholar
  68. 68.
    Badura, B., and Waltz, M., 1984, Social support and the quality of life following myocardial infarction, Soc. Indicators Res. 14: 295–311.CrossRefGoogle Scholar
  69. 69.
    Kahl, R.L., and Antonucci, T.C., 1980, Convoys over the life course, attachment, roles, and social support, in: Life-Span Development and Behavior, Volume 3 (P.B. Baltes and O.G. Brim, eds.), Academic Press, New York.Google Scholar
  70. 70.
    Mueller, D., 1980, Social networks: A promising direction for research on the relationship of the social environment to psychiatric disorder, Soc. Sci. Med. 14A: 147–161.Google Scholar
  71. 71.
    Hammer, M., 1983, “Core” and “extended” social networks in relation to health and illness, Soc. Sci. Med. 17:405–411.Google Scholar
  72. 72.
    Kaplan, B., Cassel, J., and Gore, S., 1977, Social support and health, Med. Care 15: 47–58.PubMedCrossRefGoogle Scholar
  73. 73.
    Broadhead, W.E., Kaplan, B., and James, S., 1983, The epidemiological evidence for a relationship between social support and health, Am. J. Epidemiol. 117: 521–537.PubMedGoogle Scholar
  74. 74.
    Rubin, Z., and Hartup, W. (eds.), 1983, Relationships: Their Role in Children’s Development, Cambridge University Press, New York.Google Scholar
  75. 75.
    Kiecolt-Glaser, J.K., Ricker, D., and George, J., 1984, Urinary cortisol levels, cellular immunocompetence, and loneliness in psychiatric patients, Psychosom. Med. 6: 15–23.Google Scholar
  76. 76.
    Kiecolt-Glaser, J.K., Speicher, C.E., Holliday, J.E., and Glaser, R., 1984, Stress and the transformation of lymphocytes by Epstein-Barr virus, J. Behay. Med. 7: 1–12.CrossRefGoogle Scholar
  77. 77.
    Kronfol, Z., Silva, J., Greden, J., Dembinski, S., Gardner, R., and Carroll, B., 1983, Impaired lymphocyte function in depressive illness, Life Science 33: 24 1247.Google Scholar
  78. 78.
    Ader, R., and Grota, L.J., 1973, Adrenocortical mediation of the effects of early life experiences, Prog. Brain Res. 39: 395–405.PubMedCrossRefGoogle Scholar
  79. 79.
    Henry, J.P., Stevens, P.M., and Watson, F.M., 1975, Forced breeding, social disorder, and mammary tumor formation in CBA/USC mouse colonies, Psychosom. Med. 37: 277–283.PubMedGoogle Scholar
  80. 80.
    Reite, M., Harbeck, R.J., and Hoffman, A., 1981, Altered cellular immune response following peer separation, Life Sci. 29: 1133–1136.PubMedCrossRefGoogle Scholar
  81. 81.
    Dechambre, R.P., 1981, Psychosocial stress and cancer in mice, in: Stress and Cancer ( K. Bammer and B.H. Newberry, eds.), C.J. Hogrefe, Toronto, pp. 4358.Google Scholar
  82. 82.
    Riley, V., 1979, Cancer and stress: Overview and critique, Cancer Detect. Prevent. 2: 163–195.Google Scholar
  83. 83.
    Laudenslager, M.L., Reite, M., and Harbeck, R.J., 1982, Suppressed immune response in infant monkeys associated with maternal separation, Behay. Neur. Biol. 36: 40–48.CrossRefGoogle Scholar
  84. 84.
    Coe, C.L., Rosenberg, L.T., and Levine, S., 1984, Immunological consequences of maternal separation in infant primates. Proceedings of the First International Workshop on Neuroimmunomodulation (B.H. Fox and H.N. Spector, eds.), National Institutes of Health, Washington, D.C.Google Scholar
  85. 85.
    Bowlby, J. 1980, Attachment and Loss,Volume 3, Basic Books, New York.Google Scholar
  86. 86.
    Thomas, C.B., and Greenstreet, R.L., 1973, Psychobiological characteristics in youth as predictors of five disease states: Suicide, mental illness, hypertension, coronary heart disease and tumor, Hopkins Med. J. 132: 16–43.Google Scholar
  87. 87.
    Parker, G., 1979, Parental characteristics in relation to depressive disorders, Br. J. Psychiatry 134: 138–147.PubMedCrossRefGoogle Scholar
  88. 88.
    Thomas, C.B., Duszynski, K., and Schaffer, J., 1979, Family attitudes reported in youth as potential predictors of cancer, Psychosom Med. 41: 287–302.Google Scholar
  89. 89.
    Thomas, C.B., 1981, Stamina: The thread of life, J. Chronic Dis. 34: 41–44.PubMedCrossRefGoogle Scholar
  90. 90.
    Duszynski, K., Schaffer, J., and Thomas, C.B., 1981, Neoplasm and traumatic events in childhood, Arch. Gen. Psychiatry 38: 327–333.PubMedCrossRefGoogle Scholar
  91. 91.
    O’Connor, P., and Brown, G.W., 1984, Supportive relationships: Fact or fancy ? J. Soc. Interpers. Relat. 1: 159–175.CrossRefGoogle Scholar
  92. 92.
    LeShan, L., and Worthington, R., 1956, Some recurrent life history patterns in patients with malignant disease, J. Nerv. Ment. Dis. 124: 460–465.PubMedCrossRefGoogle Scholar
  93. 93.
    LeShan, L., 1966, An emotional life history pattern associated with neoplastic disease, Ann. N.Y. Acad. Sci. 125: 780–793.PubMedCrossRefGoogle Scholar
  94. 94.
    Bahnson, C.B., 1976, Emotional and personality characteristics of cancer patients, in: Oncologic Medicine ( A.J. Sutnick and P.F. Engstrom, eds.), University Park Press, Baltimore.Google Scholar
  95. 95.
    Gecas, V., 1982, The self-concept, Annual Review of Sociology 8: 1–33.CrossRefGoogle Scholar
  96. 96.
    Davis, K.J., and Roberts, M.K., 1984, Relationships in the real world: the descriptive psychology approach to personal relationships, in: The Social Construction of the Person, ( K.J. Gergen and K.E. Davis, eds.), Springer, New York.Google Scholar
  97. 97.
    Brown, B., and Rosenbaum, L., 1984, Stress and competence, in: Stress in Childhood ( J.H. Humphrey, ed.), AMS Press, New York.Google Scholar
  98. 98.
    Waltz, M., 1986, A longitudinal study on environmental and dispositional determinants of life quality: social support and coping with physical illness, Social Indicators Research 16.Google Scholar
  99. 99.
    Rosenberg, M., 1965, Society and the Adolescent Self-Image, Princeton University Press, Princeton, N.J.Google Scholar
  100. 100.
    Simmons, R.G., and Rosenberg, F., and Rosenberg, M., 1973, Disturbances in the self-image at adolescence, Am. Sociol. Rev. 38: 553–568.PubMedCrossRefGoogle Scholar
  101. 101.
    Schwarz, J.C., 1979, Childhood origins of psychopathology, Am. Psychol. 34: 879–885.PubMedCrossRefGoogle Scholar
  102. 102.
    Pearlin, L., Lieberman, M., Menaghan, E., and Mullan, J., 1981, The stress process, J. Health Soc. Behay. 22: 337–356.CrossRefGoogle Scholar
  103. 103.
    Hetherington, Eme E.M., 1972, Effects of father absence on personality development in adolescent daughters, Dev. Psychol. 7: 313–326.CrossRefGoogle Scholar
  104. 104.
    Hetherington, E.M., 1979, Divorce: A child’s perspective, Am. Psychol. 34: 85 1858.Google Scholar
  105. 105.
    Thomas, C.B., and Duszynski, K., 1974, Closeness to parents and the family constellation in a prospective study of five disease states, Hopkins Med. J. 134: 251–270.Google Scholar
  106. 106.
    Grassi, L., and Molinari, S., 1984, Early Family Attitudes and Neoplastic Disease: A Preliminary Study, Abstracts of the Fifth Symposium on Stress and Cancer, June 1984, Kiev, EUPSYCA, Oldenburg, W. Germany.Google Scholar
  107. 107.
    Rassidakis, N.C., Lissaios, B., Vassilopoulos, R., and Athitakis, M., 1983, Continuous Parental Quarrels and Divorce and the Development of Malignant Tumors in the Offspring, unpublished manuscript, Athens.Google Scholar
  108. 108.
    Jenkins, C.D., 1983, Social environment and cancer mortality in men, N. Engl. J. Med. 308: 395–398.PubMedCrossRefGoogle Scholar
  109. 109.
    Moser, K.A., Fox, A.J., and Jones, D.R., 1984, Unemployment and mortality in the OPCS Longitudinal Study, Lancet 2: 1324–1328.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1986

Authors and Affiliations

  • Hans-Joachim F. Baltrusch
    • 1
    • 2
  • Millard E. Waltz
    • 3
  1. 1.Department of Immunehematology and Transfusion Medicine, Blood Bank, Center of Internal Medicine and DermatologyHannover Medical SchoolHannoverFederal Republic of Germany
  2. 2.International Psychooncology ProjectOldenburgFederal Republic of Germany
  3. 3.International Psychooncology Project, and Institute of SociologyUniversity of OldenburgOldenburgFederal Republic of Germany

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